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Thigpen MC, Sarath S, Soeung SC, Vichit O, Kitsutani P, Sandhu H, Gregory C, Fischer M, Morn C, Hills SL. Improving community coverage of Japanese encephalitis vaccination: lessons learned from a mass campaign in Battambang Province, Cambodia. BMC Public Health 2022; 22:2244. [PMID: 36456999 PMCID: PMC9716727 DOI: 10.1186/s12889-022-14428-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 10/23/2022] [Indexed: 12/04/2022] Open
Abstract
A mass Japanese encephalitis (JE) immunization campaign for children aged 9 months through 12 years was conducted in 2013 in Battambang province, western Cambodia. Vaccinators working at almost 2,000 immunization posts in approximately 800 villages provided vaccinations to almost 310,000 children using one dose of Chengdu Institute of Biological Products' live, attenuated SA14-14-2 JE vaccine (CD-JEV), achieving a coverage rate of greater than 90%. Lessons learned, in general for mass vaccination campaigns and specifically for vaccination with CD-JEV, are described. These observations will be of benefit for public health officials and to help inform planning for future campaigns for JE or other vaccine-preventable diseases in Cambodia and elsewhere.
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Affiliation(s)
- Michael C. Thigpen
- grid.416738.f0000 0001 2163 0069Centers for Disease Control and Prevention, Fort Collins, CO USA
| | | | - Sann Chan Soeung
- grid.415732.6National Immunization Program, Ministry of Health, Phnom Penh, Cambodia
| | - Ork Vichit
- grid.415732.6National Immunization Program, Ministry of Health, Phnom Penh, Cambodia
| | - Paul Kitsutani
- grid.416738.f0000 0001 2163 0069Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Hardeep Sandhu
- grid.416738.f0000 0001 2163 0069Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Christopher Gregory
- grid.416738.f0000 0001 2163 0069Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Marc Fischer
- grid.416738.f0000 0001 2163 0069Centers for Disease Control and Prevention, Fort Collins, CO USA
| | - Chheng Morn
- grid.415732.6National Immunization Program, Ministry of Health, Phnom Penh, Cambodia
| | - Susan L. Hills
- grid.416738.f0000 0001 2163 0069Centers for Disease Control and Prevention, Fort Collins, CO USA
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Basera TJ, Schmitz K, Price J, Willcox M, Bosire EN, Ajuwon A, Mbule M, Ronan A, Burtt F, Scheepers E, Igumbor J. Community surveillance and response to maternal and child deaths in low- and middle-income countries: A scoping review. PLoS One 2021; 16:e0248143. [PMID: 33725013 PMCID: PMC7963102 DOI: 10.1371/journal.pone.0248143] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 02/22/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Civil registration and vital statistics (CRVS) systems do not produce comprehensive data on maternal and child deaths in most low- and middle-income countries (LMICs), with most births and deaths which occur outside the formal health system going unreported. Community-based death reporting, investigation and review processes are being used in these settings to augment official registration of maternal and child deaths and to identify death-specific factors and associated barriers to maternal and childcare. This study aims to review how community-based maternal and child death reporting, investigation and review processes are carried out in LMICs. METHODS We conducted a scoping review of the literature published in English from January 2013 to November 2020, searching PubMed, EMBASE, PsycINFO, Joanna Briggs, The Cochrane Library, EBM reviews, Scopus, and Web of Science databases. We used descriptive analysis to outline the scope, design, and distribution of literature included in the study and to present the content extracted from each article. The scoping review is reported following the PRISMA reporting guideline for systematic reviews. RESULTS Of 3162 screened articles, 43 articles that described community-based maternal and child death review processes across ten countries in Africa and Asia were included. A variety of approaches were used to report and investigate deaths in the community, including identification of deaths by community health workers (CHWs) and other community informants, reproductive age mortality surveys, verbal autopsy, and social autopsy. Community notification of deaths by CHWs complements registration of maternal and child deaths missed by routinely collected sources of information, including the CRVS systems which mostly capture deaths occurring in health facilities. However, the accuracy and completeness of data reported by CHWs are sub-optimal. CONCLUSIONS Community-based death reporting complements formal registration of maternal and child deaths in LMICs. While research shows that community-based maternal and child death reporting was feasible, the accuracy and completeness of data reported by CHWs are sub-optimal but amenable to targeted support and supervision. Studies to further improve the process of engaging communities in the review, as well as collection and investigation of deaths in LMICs, could empower communities to respond more effectively and have a greater impact on reducing maternal and child mortality.
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Affiliation(s)
- Tariro J. Basera
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- * E-mail:
| | | | - Jessica Price
- MRC-Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Merlin Willcox
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom
| | - Edna N. Bosire
- South African Medical Research Council Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ademola Ajuwon
- Department of Health Promotion and Education, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | | | | | | | | | - Jude Igumbor
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Suthar AB, Khalifa A, Yin S, Wenz K, Ma Fat D, Mills SL, Nichols E, AbouZahr C, Mrkic S. Evaluation of approaches to strengthen civil registration and vital statistics systems: A systematic review and synthesis of policies in 25 countries. PLoS Med 2019; 16:e1002929. [PMID: 31560684 PMCID: PMC6764661 DOI: 10.1371/journal.pmed.1002929] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/30/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Civil registration and vital statistics (CRVS) systems play a key role in upholding human rights and generating data for health and good governance. They also can help monitor progress in achieving the United Nations Sustainable Development Goals. Although many countries have made substantial progress in strengthening their CRVS systems, most low- and middle-income countries still have underdeveloped systems. The objective of this systematic review is to identify national policies that can help countries strengthen their systems. METHODS AND FINDINGS The ABI/INFORM, Embase, JSTOR, PubMed, and WHO Index Medicus databases were systematically searched for policies to improve birth and/or death registration on 24 January 2017. Global stakeholders were also contacted for relevant grey literature. For the purposes of this review, policies were categorised as supply, demand, incentive, penalty, or combination (i.e., at least two of the preceding policy approaches). Quantitative results on changes in vital event registration rates were presented for individual comparative articles. Qualitative systematic review methodology, including meta-ethnography, was used for qualitative syntheses on operational considerations encompassing acceptability to recipients and staff, human resource requirements, information technology or infrastructure requirements, costs to the health system, unintended effects, facilitators, and barriers. This study is registered with PROSPERO, number CRD42018085768. Thirty-five articles documenting experience in implementing policies to improve birth and/or death registration were identified. Although 25 countries representing all global regions (Africa, the Americas, Southeast Asia, the Western Pacific, Europe, and the Eastern Mediterranean) were reflected, there were limited countries from the Eastern Mediterranean and Europe regions. Twenty-four articles reported policy effects on birth and/or death registration. Twenty-one of the 24 articles found that the change in registration rate after the policy was positive, with two supply and one penalty articles being the exceptions. The qualitative syntheses identified 15 operational considerations across all policy categories. Human and financial resource requirements were not quantified. The primary limitation of this systematic review was the threat of publication bias wherein many countries may not have documented their experience; this threat is most concerning for policies that had neutral or negative effects. CONCLUSIONS Our systematic review suggests that combination policy approaches, consisting of at least a supply and demand component, were consistently associated with improved registration rates in different geographical contexts. Operational considerations should be interpreted based on health system, governance, and sociocultural context. More evaluations and research are needed from the Eastern Mediterranean and Europe regions. Further research and evaluation are also needed to estimate the human and financial resource requirements required for different policies.
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Affiliation(s)
- Amitabh Bipin Suthar
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | - Aleya Khalifa
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sherry Yin
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kristen Wenz
- Programme Division, United Nations Children’s Fund, New York City, New York, United States of America
| | - Doris Ma Fat
- Health Statistics and Informatics Department, World Health Organization, Geneva, Switzerland
| | - Samuel Lantei Mills
- Health, Nutrition, and Population Global Practice, World Bank Group, Washington DC, United States of America
| | - Erin Nichols
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, United States of America
| | - Carla AbouZahr
- Bloomberg Data for Health Initiative, New York City, New York, United States of America
| | - Srdjan Mrkic
- Statistics Division, United Nations, New York City, New York, United States of America
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Corrêa G, Verstraete P, Soundardjee R, Shankar M, Paterson C, Hampton L, Jackson D, Muniz M, Mwamba R, Wenz K, Bratschi MW, AbouZahr C, Johnson H. Immunization programmes and notifications of vital events. Bull World Health Organ 2019; 97:306-308. [PMID: 30940988 PMCID: PMC6438247 DOI: 10.2471/blt.18.210807] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 12/10/2018] [Accepted: 12/25/2018] [Indexed: 11/27/2022] Open
Affiliation(s)
- Gustavo Corrêa
- Gavi, the Vaccine Alliance, Global Health Campus, Chemin du Pommier 40, 1218 Grand-Saconnex Geneva, Switzerland
| | - Philippe Verstraete
- Gavi, the Vaccine Alliance, Global Health Campus, Chemin du Pommier 40, 1218 Grand-Saconnex Geneva, Switzerland
| | - Riswana Soundardjee
- Gavi, the Vaccine Alliance, Global Health Campus, Chemin du Pommier 40, 1218 Grand-Saconnex Geneva, Switzerland
| | - Manjari Shankar
- Gavi, the Vaccine Alliance, Global Health Campus, Chemin du Pommier 40, 1218 Grand-Saconnex Geneva, Switzerland
| | - Colin Paterson
- Gavi, the Vaccine Alliance, Global Health Campus, Chemin du Pommier 40, 1218 Grand-Saconnex Geneva, Switzerland
| | - Lee Hampton
- Gavi, the Vaccine Alliance, Global Health Campus, Chemin du Pommier 40, 1218 Grand-Saconnex Geneva, Switzerland
| | - Debra Jackson
- Health section, United Nations Children's Fund, New York, United States of America (USA)
| | - Maria Muniz
- Health section, United Nations Children's Fund, New York, United States of America (USA)
| | - Remy Mwamba
- Health section, United Nations Children's Fund, New York, United States of America (USA)
| | - Kristen Wenz
- Child Protection section, United Nations Children's Fund, New York, USA
| | | | - Carla AbouZahr
- Bloomberg Data for Health Initiative, University of Melbourne, Melbourne, Australia
| | - Hope Johnson
- Gavi, the Vaccine Alliance, Global Health Campus, Chemin du Pommier 40, 1218 Grand-Saconnex Geneva, Switzerland
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Munthali CVT, Kang'oma S, Nasasara K, Zaina LM, Lupafya C, Mziya J, Harries AD, Takarinda KC, Kwataine M, Dambula I, Yosefe S. Can a Village Headman Use an Electronic Village Register and a Simplified Community-Based Verbal Autopsy Tool to Record Numbers and Causes of Death in Rural Malawi? Front Public Health 2018; 6:246. [PMID: 30234090 PMCID: PMC6131634 DOI: 10.3389/fpubh.2018.00246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 08/15/2018] [Indexed: 10/28/2022] Open
Abstract
Introduction: Most people in Africa die without appearing in official vital statistics records. To improve this situation, Malawi has introduced solar-powered electronic village registers (EVR), managed by village headmen, to record birth and death information for production of vital statistics. The EVR is deployed in 83 villages in Traditional Authority Mtema, Lilongwe, which is an area without electricity. In 17 villages, village headmen were also trained to use a simple verbal autopsy (VA) tool adapted from one developed by the World Health Organization (WHO). Study objectives were to (i) document numbers and causes of death occurring in 17 villages between April 2016 and September 2017, and (ii) assess percentage measures of agreement on causes of death as recorded by village headmen using a simple VA tool and by a team of health surveillance assistant (HSA)/medical doctor using the WHO VA tool. Methods: The study was in two-parts: (i) a cross-sectional study using secondary data from the EVR; (ii) primary data collection study comparing causes of death obtained by village headmen using a simple VA tool and by HSA/medical doctor using the WHO VA tool. Results: Over 18 months, 120 deaths were recorded by EVR in 14,264 residents - crude annual death rate 5.6/1,000 population. Median age at death was 43 years with 69 (58%) deaths being in males. Death occurred at home (75%) and at health facility (25%). Malaria, diarrhoeal disease, pulmonary tuberculosis, acute respiratory infection, and stroke accounted for 56% of deaths recorded by village headmen using the simple VA tool. Causes of death between village headmen and the HSA/medical doctor team were compared for 107 deaths. There was full agreement in causes of death in 33 (31%) deaths, mostly for malaria, severe anemia, intentional self-harm, cancer, and epilepsy. Unknown-sudden death and sepsis recorded by the HSA/medical doctor team were responsible for most disagreements. Conclusion: It is feasible for village headmen in rural Malawi to use an EVR and simple VA tool to document numbers and causes of deaths. More work is needed to improve accuracy of causes of death by village headmen.
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Affiliation(s)
| | - Sophie Kang'oma
- Ministry of Home Affairs and Internal Security, National Registration Bureau, Lilongwe, Malawi
| | | | | | | | | | - Anthony D Harries
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - Isaac Dambula
- Central Monitoring and Evaluation Division, Ministry of Health, Lilongwe, Malawi
| | - Simeon Yosefe
- Central Monitoring and Evaluation Division, Ministry of Health, Lilongwe, Malawi
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Gadabu OJ, Ben-Smith A, Douglas GP, Chirwa-Nasasara K, Manjomo RC, Harries AD, Dambula I, Kang'oma S, Chiumia T, Chinsinga FB. Scaling up electronic village registers for measuring vital statistics in rural villages in Malawi. Public Health Action 2018; 8:79-84. [PMID: 29946524 DOI: 10.5588/pha.17.0116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 05/14/2018] [Indexed: 11/10/2022] Open
Abstract
Setting: Eighty-three villages without electricity in Mtema Traditional Authority, Lilongwe District, Malawi. Objectives: To describe 1) the expansion of the electronic village register (EVR) to 83 villages in Mtema Traditional Authority, 2) the challenges encountered and changes made to render the system robust and user-friendly, 3) the value propositions developed to increase the system's desirability, and 4) the results of the village register. Design: Descriptive study. Results: After the deployment of the EVR in one village in 2013, the system was extended to 83 villages with modifications to render it more robust and user-friendly. These changes included modifications to the power, connectivity and work stations, better battery security and a single modular electronics panel. Value propositions of the EVR for the village headmen included daily postings of news/sports items and sockets for charging mobile phones and lanterns. Of the 47 559 residents registered, 48% were male, 14% were aged 0-4 years, 43% were aged 15-44 years and 4% were aged ⩾65 years. Between 1 April 2016 and 31 March 2017, 976 births and 177 deaths were recorded. The total equipment cost per village was US$2430. Conclusion: An electronic village birth and death registration system can function in an area with no communication or electricity infrastructure.
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Affiliation(s)
| | - A Ben-Smith
- Baobab Health Trust, Lilongwe, Malawi.,Center for Health Informatics for the Underserved, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - G P Douglas
- Center for Health Informatics for the Underserved, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | | | - A D Harries
- International Union Against Tuberculosis and Lung Disease, Paris, France.,London School of Hygiene & Tropical Medicine, London, UK
| | - I Dambula
- Central Monitoring and Evaluation Division, Ministry of Health, Lilongwe, Malawi
| | - S Kang'oma
- National Registration Bureau, Ministry of Home Affairs and Internal Security, Lilongwe, Malawi
| | - T Chiumia
- National Registration Bureau, Ministry of Home Affairs and Internal Security, Lilongwe, Malawi
| | - F B Chinsinga
- National Registration Bureau, Ministry of Home Affairs and Internal Security, Lilongwe, Malawi
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Simek A. Navigare necesse est! Research to understand our body and soul, to heal the patients, to find ourselves. MEDICAL SCIENCE PULSE 2018. [DOI: 10.5604/01.3001.0011.7489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The image of a researcher is a distinguished, enthusiastic doctor in a fresh, washed and ironed white lab coat
working in a clinic or research-centre. The research is well-financed, supported by different scientific and/or
economic firms, and the aim is to understand the human body and its physiologic processes in atomic level for
getting the best, mostly very expensive, and sometimes uneasy medical treatment for the patient.
Nowadays on top of the most modern sciences there is the specialist, who lives in an ivory tower and knows almost everything about diseases and sciences. Try to get off to this land!
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Affiliation(s)
- Agnes Simek
- Semmelweis Medical University, Public Health Department, Budapest, Hungary
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Opportunities and obstacles using a clinical decision support system for maternal care in Burkina Faso. Online J Public Health Inform 2017; 9:e188. [PMID: 29026454 DOI: 10.5210/ojphi.v9i2.7905] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Maternal and neonatal mortality is high in sub-Saharan Africa. To support Healthcare Workers (HCWs), a computerized decision support system (CDSS) was piloted at six rural maternal care units in Burkina Faso. During the two years of the study period, it was apparent from reports that the CDSS was not used regularly in clinical practice. This study aimed to explore the reasons why HCWs failed to use the CDSS. METHODS A workshop, organized as group discussions and a plenary session, was performed with 13 participants to understand their experience with the CDSS and suggest improvements if pertinent. Workshop transcripts were analyzed thematically. Socio-demographic and usage patterns of the CDSS were examined by a questionnaire and analyzed descriptively. RESULTS The participants reported that the contextual basic conditions for using the CDSS were not fulfilled. These included unreliable power supply, none user-friendly partograph, the CDSS was not integrated with workflow and staff lacked motivational incentives. Despite these limitations, the HCWs reported learning benefits from guidance and alerts in the CDSS. Using the CDSS enabled them to discover problems earlier as they learned to focus on symptoms to prevent harmful situations. CONCLUSION The CDSS was not tailored to the needs and context of the users. The HCWs, defined their needs and suggested how the CDSS should be re-designed. This suggests that the successful and regular usage of any CDSS in rural settings requires the involvement of users throughout the construction and pilot-testing phases and not only during the early prototype design period.
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Abstract
Jennifer Bryce and the RMM Working Group describe the origin and rationale of the Real-Time Monitoring of Under-Five Mortality Collection.
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Affiliation(s)
- Jennifer Bryce
- Institute for International Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- * E-mail:
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Notzon FC. Implementing civil registration in a challenging environment. Public Health Action 2014; 4:136-7. [PMID: 26393081 DOI: 10.5588/pha.14.0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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